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I finally got to meet the radiation oncologist, Dr. Figura, and the medical oncologist who is in charge of chemo, Dr. Li. My entire medical team had met that morning to talk about the results from all my tests and come up with a treatment plan. I will be getting chemo first in order to shrink the tumor to a size that is more easily operable, surgery, and then radiation treatment.

We met with Dr. Figura first, even though I’ll be under his care last. He talked a bit about how radiation therapy works. in my case, I’ll be getting 28-33 doses, five times a week until it’s done. The best thing was being able to see my PET scan. I love the digital imaging that doctor’s have access to these days. The PET imaged slices of my body, and you could see all the different parts – my favorite was the parts of the skull and the cross-section of my shoulder.

Dr. Li went over the results of my previous tests. The breast MRI showed no abnormalities in the left breast, and no chest wall or skin involvement on the right. Unequivocal good news! The PET scan, since it was a whole body scan, found a few abnormalities. Good news first – no involvement in the lungs, liver, or bones (the common places breast cancer spreads). They did find a dark spot on one of my kidneys. Since it’s dark, we know it’s not the breast cancer. It’s probably just a cyst, but it could theoretically be renal cancer, so I need a CT scan with contrast to check. Also, the ovaries showed some abnormalities, but it was unclear what’s going on (not enough intra-abdominal fat to resolve the image). So, I need an ultrasound to check that out. Also, I need a baseline MUGA test to check my heart functions. Off to schedule more tests!

So, before I start treatment, the doctors wanted to know how far the cancer has spread. We know it’s in the axillary lymph nodes, based on the biopsy, which means it could move about in the lymphatic system. Also, since it is lobular carcinoma, there’s a higher probability of it showing up in the opposite breast. Therefore, I was off to a PET scan and a breast MRI. With all the tests and injections for contrast, I’m also starting my own personal element collection of injections.

Breast MRI. They have you lay face first on a cut-out structure so your breasts can hang down, and a plastic line goes down your breastbone. Your arms go over your head, and luckily there was no pressure on my port site or I couldn’t have done it. You get sent into the machine on your stomach, with a blanket over your eyes, so there’s no worries about claustrophobia. I even got headphones with my choice of music, not that I could hear it half the time because of the noise of the machine. They used an IV to inject the contract agent about half way through the test. I could feel the coldness as it flowed over the skin on my arm, but otherwise nothing. I did not enjoy the MRI because of the noise. So many different loud noises, randomly starting and stopping. Then, when you get out, you can hardly breathe because of the pressure on your breastbone that was supporting your weight during the test.

Element added: Gadolinium

PET scan. I had to fast for six hours before this test, although since it was first thing in the morning, it just meant skipping breakfast. They inject you with fluorine-doped glucose (I picked the other arm for the injection), that would move to any part of the body that was using lots of energy. To minimize false positives, and to make sure only cancer cells glow on the test, they inject you with the glucose, and have you sit quietly. You can listen to music, podcasts, or watch TV. No talking, no reading, just sitting quietly. After an hour, they send you through another tube. This one is at least quiet. They move you through the tube at a constant rate for an initial CT. After the CT is done, you sit at specific points in the tube, starting at the head and moving down the body, pausing for 5-10 minutes for each section. The isotope of fluorine they used had a half-life of only 110 minutes, but I was radioactive for the rest of the day. They even gave me a card if I went to the airport or court-house to show I wasn’t trying to bomb the place – just had a PET scan that day.